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R104: Atherosclerosis, Tympanosclerosis and Blood Cholesterol
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Otolaryngology-Head and Neck Surgery, Vol 137, No 2S, August 2007
detected in the MEL taken at surgery, or through a perforated tympanic membrane, and in the otorrhea from suspected PLF cases after head or middle ear trauma. CONCLUSION: These results strongly suggest that CTP is a specific and sensitive biochemical marker for detecting PLF. SIGNIFICANCE: This novel test using CTP would serve as a definite diagnostic tool for PLF to be used routinely in patients with hearing loss/vestibular disorders, especially after trauma. Further studies using this test will provide newer insights into the etiology, pathomechanisms, prevalence and natural history of PLF, and therapeutic and preventive strategies for acute or late-onset neuro-otological conditions. SUPPORT: This study was supported by Health and Labor Sciences Research Grants in Japan (Research on Measures for Intractable Diseases, Researches on Sensory and Communicative Disorders), a grant from the Ministry of Education, Culture, Sports, Science and Technol
R103 Epithelial Migration on the Atelectatic Tympanic Membrane Narayanan Prepageran, FRCS, MS (presenter); Ing-Ping Tang, MD; Raman Rajagopalan, MS, DLO PROBLEM: Objective: The study aims to determine whether the atelectatic pars tensa tympanic membrane secondary to any pathology will still behave in a way similar to a normal nonpathological ear drum, by calculating and comparing the epithelial migration rate and pattern. METHODS: A total of 15 subjects with 30 ears were selected from an otorhinolaryngology outpatient clinic, UMMC, from April 2006 to November 2006. The selected ears were examined under an operating microscope. Methylene blue ink dot was applied to the epithelium of atelectatic pars tensa TM at the central area of the retraction and to the same place on the normal TM; weekly follow-up was performed until the migratory pattern and the rate of epithelial migration were noted and stopped when the methylene blue ink dot migrated to the annulus of the TM. RESULTS: Twelve out of 15 subjects (80%) showed similar patterns in both control and study ear of each subject; 53% of subjects showed epithelial migration at antero-superior direction of TM; 86.6% of subjects were studied for 8 weeks throughout this study. No migration noted at study TM for the first week. A mean rate of 62.5micrometer/day with range of 52.2-71.4 micrometer/day was noted in epithelial migration of study TM. The mean epithelial migratory rate for control normal TM was 65.1 micrometer/day. The rate of migration increased while approaching the annulus of TM for both control and study TM. CONCLUSION: This preliminary study concludes that there is no difference in the epithelial migration rate and pattern between atelectatic pars tensa TM and normal TM. This study
will continue to obtain a bigger sample and more convincing results statistically. SIGNIFICANCE: Deepen the understanding of the causes of cholesteatoma and when a pocket stops self-cleansing. SUPPORT: nil
R104 Atherosclerosis, Tympanosclerosis and Blood Cholesterol Narayanan Prepageran, FRCS, MS (presenter); Raman Rajagopalan, MS, DLO; Shailendra Sivalingam, MBBS, MS(ORL- HNS) PROBLEM: Objective: To determine if patients with atherosclerosis have a greater occurrence of tympanosclerosis and to determine if blood cholesterol levels were a significant factor in the occurrence of tympanosclerosis. METHODS: Methods and Material: Prospective controlled Study in University Malaya Medical Centre from January 2005–June 2005. Study consisted of 2 groups. Study group: atherosclerotic predisposition (from angiogram) and control group: non-atherosclerotic predisposition (patients were age and sex matched). The patients were examined for tympanosclerosis and had their blood cholesterol checked and compared statistically. RESULTS: A total of 75 patients were included in each group. In the study group, tympanosclerosis was present in 34.66%; 46.7% of patients had raised total cholesterol (TC) levels, 45/75 patients had raised TG levels (60%), while 26 tympanosclerotic patients had raised TC levels (46%). In comparison (in control group), 10 patients had tympanosclerosis (13.33%), 11/75 had raised TC levels (14.7%), 5/75 had raised TG levels (6.7%) and 3/10 with tympanosclerosis had raised TC levels (30%). These and other parameters were compared for statistical significance. CONCLUSION: There is a statistically significant relationship between atherosclerosis and tympanosclerosis. There was no statistically significant difference in the cholesterol levels of atherosclerotic and non-atherosclerotic patients. There is no statistically significant relationship between elevated blood cholesterol levels and development of tympanosclerosis. SIGNIFICANCE: Exploring the possible relationship between blood cholesterol, tympanosclerosis and artherosclerosis. SUPPORT: nil
R105 Validation of a Temporal Bone Dissection Simulator Jeffery C Rastatter, MD (presenter); Greg Wiet, MD; Sumit Bapna, MD; Marc Packard, MD; Alan Richard Grimm PROBLEM: The problem of limited cadaveric temporal bones for residency training programs could be addressed by incorporating computerized virtual temporal bone dissections in residency
Otolaryngology-Head and Neck Surgery, Vol 137, No 2S, August 2007
detected in the MEL taken at surgery, or through a perforated tympanic membrane, and in the otorrhea from suspected PLF cases after head or middle ear trauma. CONCLUSION: These results strongly suggest that CTP is a specific and sensitive biochemical marker for detecting PLF. SIGNIFICANCE: This novel test using CTP would serve as a definite diagnostic tool for PLF to be used routinely in patients with hearing loss/vestibular disorders, especially after trauma. Further studies using this test will provide newer insights into the etiology, pathomechanisms, prevalence and natural history of PLF, and therapeutic and preventive strategies for acute or late-onset neuro-otological conditions. SUPPORT: This study was supported by Health and Labor Sciences Research Grants in Japan (Research on Measures for Intractable Diseases, Researches on Sensory and Communicative Disorders), a grant from the Ministry of Education, Culture, Sports, Science and Technol
R103 Epithelial Migration on the Atelectatic Tympanic Membrane Narayanan Prepageran, FRCS, MS (presenter); Ing-Ping Tang, MD; Raman Rajagopalan, MS, DLO PROBLEM: Objective: The study aims to determine whether the atelectatic pars tensa tympanic membrane secondary to any pathology will still behave in a way similar to a normal nonpathological ear drum, by calculating and comparing the epithelial migration rate and pattern. METHODS: A total of 15 subjects with 30 ears were selected from an otorhinolaryngology outpatient clinic, UMMC, from April 2006 to November 2006. The selected ears were examined under an operating microscope. Methylene blue ink dot was applied to the epithelium of atelectatic pars tensa TM at the central area of the retraction and to the same place on the normal TM; weekly follow-up was performed until the migratory pattern and the rate of epithelial migration were noted and stopped when the methylene blue ink dot migrated to the annulus of the TM. RESULTS: Twelve out of 15 subjects (80%) showed similar patterns in both control and study ear of each subject; 53% of subjects showed epithelial migration at antero-superior direction of TM; 86.6% of subjects were studied for 8 weeks throughout this study. No migration noted at study TM for the first week. A mean rate of 62.5micrometer/day with range of 52.2-71.4 micrometer/day was noted in epithelial migration of study TM. The mean epithelial migratory rate for control normal TM was 65.1 micrometer/day. The rate of migration increased while approaching the annulus of TM for both control and study TM. CONCLUSION: This preliminary study concludes that there is no difference in the epithelial migration rate and pattern between atelectatic pars tensa TM and normal TM. This study
will continue to obtain a bigger sample and more convincing results statistically. SIGNIFICANCE: Deepen the understanding of the causes of cholesteatoma and when a pocket stops self-cleansing. SUPPORT: nil
R104 Atherosclerosis, Tympanosclerosis and Blood Cholesterol Narayanan Prepageran, FRCS, MS (presenter); Raman Rajagopalan, MS, DLO; Shailendra Sivalingam, MBBS, MS(ORL- HNS) PROBLEM: Objective: To determine if patients with atherosclerosis have a greater occurrence of tympanosclerosis and to determine if blood cholesterol levels were a significant factor in the occurrence of tympanosclerosis. METHODS: Methods and Material: Prospective controlled Study in University Malaya Medical Centre from January 2005–June 2005. Study consisted of 2 groups. Study group: atherosclerotic predisposition (from angiogram) and control group: non-atherosclerotic predisposition (patients were age and sex matched). The patients were examined for tympanosclerosis and had their blood cholesterol checked and compared statistically. RESULTS: A total of 75 patients were included in each group. In the study group, tympanosclerosis was present in 34.66%; 46.7% of patients had raised total cholesterol (TC) levels, 45/75 patients had raised TG levels (60%), while 26 tympanosclerotic patients had raised TC levels (46%). In comparison (in control group), 10 patients had tympanosclerosis (13.33%), 11/75 had raised TC levels (14.7%), 5/75 had raised TG levels (6.7%) and 3/10 with tympanosclerosis had raised TC levels (30%). These and other parameters were compared for statistical significance. CONCLUSION: There is a statistically significant relationship between atherosclerosis and tympanosclerosis. There was no statistically significant difference in the cholesterol levels of atherosclerotic and non-atherosclerotic patients. There is no statistically significant relationship between elevated blood cholesterol levels and development of tympanosclerosis. SIGNIFICANCE: Exploring the possible relationship between blood cholesterol, tympanosclerosis and artherosclerosis. SUPPORT: nil
R105 Validation of a Temporal Bone Dissection Simulator Jeffery C Rastatter, MD (presenter); Greg Wiet, MD; Sumit Bapna, MD; Marc Packard, MD; Alan Richard Grimm PROBLEM: The problem of limited cadaveric temporal bones for residency training programs could be addressed by incorporating computerized virtual temporal bone dissections in residency